How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $549.54 Median $3,715.35 Typical High $11,481.54 | Facility | None | $549.54 | $3,715.35 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $204.17 | Professional | None | $141.25 | $151.36 | $204.17 |
AvMed Setting Facility Modifier None Typical Low $165.96 Median $2,137.96 Typical High $11,748.98 | Facility | None | $165.96 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $199.53 | Professional | None | $138.04 | $173.78 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,445.44 Typical High $2,691.53 | Facility | None | $489.78 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $338.84 | Professional | None | $131.83 | $177.83 | $338.84 |
Florida Blue Setting Facility Modifier None Typical Low $524.81 Median $1,071.52 Typical High $11,748.98 | Facility | None | $524.81 | $1,071.52 | $11,748.98 |
Florida Blue Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $173.78 | Professional | None | $114.82 | $123.03 | $173.78 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $295.12 | Professional | None | $85.11 | $147.91 | $295.12 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $5,623.41 | Facility | None | $398.11 | $1,000.00 | $5,623.41 |
United Setting Professional Modifier None Typical Low $60.26 Median $194.98 Typical High $371.54 | Professional | None | $60.26 | $194.98 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $38.90 | Professional | 53 · Discontinued | $28.18 | $30.20 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $104.71 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $100.00 | $104.71 | $134.90 |
Where Florida sits
The same service costs 8.7 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Florida· 20th of 51
$295
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.